Texas Standardized Credentialing Application

Texas Standardized Credentialing Application Attachment A – Other Professional Degrees

OTHER PROFESSIONAL DEGREE
Issuing Institution:
ADDRESS
CITY STATE/COUNTRY POSTAL CODE
DEGREE / ATTENDANCE DATES(MM/YYYY TO MM/YYYY)
OTHER PROFESSIONAL DEGREE
Issuing Institution:
ADDRESS
CITY STATE/COUNTRY POSTAL CODE
DEGREE / ATTENDANCE DATES(MM/YYYY TO MM/YYYY)
OTHER PROFESSIONAL DEGREE
Issuing Institution:
ADDRESS
CITY STATE/COUNTRY POSTAL CODE
DEGREE / ATTENDANCE DATES(MM/YYYY TO MM/YYYY)
OTHER PROFESSIONAL DEGREE
Issuing Institution:
ADDRESS
CITY STATE/COUNTRY POSTAL CODE
DEGREE / ATTENDANCE DATES(MM/YYYY TO MM/YYYY)
OTHER PROFESSIONAL DEGREE
Issuing Institution:
ADDRESS
CITY STATE/COUNTRY POSTAL CODE
DEGREE / ATTENDANCE DATES(MM/YYYY TO MM/YYYY)
OTHER PROFESSIONAL DEGREE
Issuing Institution:
ADDRESS
CITY STATE/COUNTRY POSTAL CODE
DEGREE / ATTENDANCE DATES(MM/YYYY TO MM/YYYY)
OTHER PROFESSIONAL DEGREE
Issuing Institution:
ADDRESS
CITY STATE/COUNTRY POSTAL CODE
DEGREE / ATTENDANCE DATES(MM/YYYY TO MM/YYYY)

LHL234a Rev.01/07 13 of 20